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Four-Factor Model Predicts Mortality With Bariatric Surgery

Four-Factor Model Predicts Mortality With Bariatric Surgery

(HealthDay News) – A model taking into account four different factors best predicts mortality with bariatric surgery, while a composite measure best profiles hospital performance of the surgery, according to two studies published online Oct. 16 in JAMA Surgery.

Raj S. Padwal, MD, from the University of Alberta in Edmonton, Canada, and colleagues used data from 15,394 adults aged 18–65 years from a U.K. population-representative primary care registry to identify appropriate criteria for selection of obese individuals for bariatric surgery. During a mean follow-up of 9.9 years, the researchers found that all-cause mortality was 2.1%. The study model, which included age, type 2 diabetes, current smoking, and male gender, had a C-statistic of 0.768. Body mass index significantly predicted mortality but did not improve discrimination or calibration of the model.

Justin B. Dimick, MD, MPH, from the University of Michigan in Ann Arbor, and colleagues used clinical registry data from all patients undergoing bariatric surgery from 2008–2010 to create a composite measure for profiling hospital performance with bariatric surgery, including serious complications, reoperations, and readmissions; hospital and surgeon volume; and outcomes with other related procedures. The researchers found that, compared with other measures, the composite measure explained a larger proportion of hospital-level variation in serious complication rates with laparoscopic gastric bypass. Compared with individual measures, the composite measure was also better at predicting future performance.

"In this preliminary study, it appears that such composite measures may be better than existing alternatives for profiling hospital performance with bariatric surgery," Dimick and colleagues write.

Several authors from the Padwal study disclosed financial ties to the pharmaceutical and medical device industries.